{ Media Request : LPSS : Lafayette Parish School System }

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Your Name *	Your Title	Your School

Contact person for the event	Contact person's cell phone *	Contact person's phone
for media interviews	for Marketing Dept. use only	for media use
Name of event *	Date of event *	Time of event
		to
Location of event	Age of children involved	Number of children involved

Is the public invited?	Are parents invited?
Yes No	Yes No
Short description of the event *

Visual possibilities (list anything with action, colorful, outside, something that a photographer or videographer can capture)

Are there any children involved who cannot be photographed or recorded?
Yes No
Please explain

Are there any community members/groups/businesses who should be mentioned in the press release?
Yes No
Please explain

Who will be available on-site to assist the media on the day of the event?

Do you want a member of the Marketing staff to attend this event to assist the media for you? *
Yes No
Do you need a member of the Marketing staff to call you to discuss this event? *
Yes No
Please add anything else you need us to know